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European Heart Journal. Acute Cardiovascular Care

Lina Ljung, Martin Sundqvist, Tomas Jernberg, Kai M Eggers, Gunnar Ljunggren, Mats Frick
BACKGROUND: The aim of this study was to examine the value of predischarge exercise electrocardiogram (ECG) testing of chest pain patients in whom acute myocardial infarction (MI) had been ruled out by means of high-sensitivity troponins, ECG and history. METHODS: All patients hospitalised for chest pain who underwent exercise ECG testing before discharge from the Department of Cardiology, Södersjukhuset, Stockholm, Sweden from January 2011 to June 2012 were included...
January 1, 2017: European Heart Journal. Acute Cardiovascular Care
Mackram F Eleid, Marysia S Tweet, Phillip M Young, Eric Williamson, Sharonne N Hayes, Rajiv Gulati
BACKGROUND: There is limited understanding of the role of cardiac computed tomography angiography (CCTA) for assessment of patients with spontaneous coronary artery dissection (SCAD). METHODS: In this report we describe the diagnostic utility of CCTA in three young women presenting with signs and symptoms of myocardial ischemia who were eventually diagnosed with SCAD. RESULTS: None of the women had traditional atherosclerotic risk factors...
January 1, 2017: European Heart Journal. Acute Cardiovascular Care
Akiomi Yoshihisa, Satoshi Abe, Yu Sato, Shunsuke Watanabe, Tetsuro Yokokawa, Shunsuke Miura, Tomofumi Misaka, Takamasa Sato, Satoshi Suzuki, Masayoshi Oikawa, Atsushi Kobayashi, Takayoshi Yamaki, Hiroyuki Kunii, Shu-Ichi Saitoh, Yasuchika Takeishi
BACKGROUND: The intravascular compartment is known as the plasma volume, and the extravascular compartment represents fluid within the interstitial space. Plasma volume expansion is a major symptom of heart failure. The aim of the current study was to investigate the impact of plasma volume status on the prognosis of acute heart failure syndromes. METHODS AND RESULTS: We analyzed 1115 patients with acute heart failure syndromes who were admitted to our hospital...
January 1, 2017: European Heart Journal. Acute Cardiovascular Care
Edward Koifman, Roy Beigel, Zaza Iakobishvili, Nir Shlomo, Yitschak Biton, Avi Sabbag, Elad Asher, Shaul Atar, Shmuel Gottlieb, Ronny Alcalai, Doron Zahger, Amit Segev, Ilan Goldenberg, Rafael Strugo, Shlomi Matetzky
BACKGROUND: Ischemic time has prognostic importance in ST-elevation myocardial infarction patients. Mobile intensive care unit use can reduce components of total ischemic time by appropriate triage of ST-elevation myocardial infarction patients. METHODS: Data from the Acute Coronary Survey in Israel registry 2000-2010 were analyzed to evaluate factors associated with mobile intensive care unit use and its impact on total ischemic time and patient outcomes. RESULTS: The study comprised 5474 ST-elevation myocardial infarction patients enrolled in the Acute Coronary Survey in Israel registry, of whom 46% ( n=2538) arrived via mobile intensive care units...
January 1, 2017: European Heart Journal. Acute Cardiovascular Care
Maycel Ishak, Danish Ali, Marion J Fokkert, Robbert J Slingerland, Rudolf T Tolsma, Erik Badings, Aize van der Sluis, Fred van Eenennaam, Arend Mosterd, Jurriën M Ten Berg, Arnoud Wj van 't Hof
BACKGROUND: The first study of the FamouS Triage project investigates the feasibility of ruling out a myocardial infarction in pre-hospital chest pain patients without electrocardiographic ST-segment elevation by using the modified HEART score at the patient's home, incorporating only a single highly sensitive troponin T measurement. METHODS: A venous blood sample was drawn in the ambulance from 1127 consecutive chest pain patients for measurement of the pre-hospital highly sensitive troponin T levels, in order to establish a pre-hospital HEART score (i...
January 1, 2017: European Heart Journal. Acute Cardiovascular Care
Julien Magne, Baptiste Salerno, Dania Mohty, Claire Serena, Florence Rolle, Alessandro Piccardo, Najmeddine Echahidi, Alexandre Le Guyader, Victor Aboyans
OBJECTIVE: Postoperative atrial fibrillation is a major complication following coronary artery bypass graft. We hypothesized that, beyond clinical and electrocardiogram (ECG) data, transthoracic echocardiography could improve the prediction of postoperative atrial fibrillation. METHODS: We prospectively studied 169 patients in sinus rhythm who underwent isolated coronary artery bypass graft in our institution. Clinical, biological, ECG and transthoracic echocardiography data were collected within 24 h before surgery...
January 1, 2017: European Heart Journal. Acute Cardiovascular Care
Benedikt Schrage, Hanno Grahn, Florian M Wagner, Alexander Bernhardt, Meike Rybczynski, Stefan Blankenberg, Hermann Reichenspurner, Markus J Barten
BACKGROUND: Pump thrombosis is a major complication of the continuous flow left ventricular assist device. Pump exchange is seen as the therapeutic gold standard. In this study, we report on our experience with using tissue-type plasminogen activator thrombolysis for therapy of pump thrombosis. METHODS: We report on our experience with treatment of continuous flow left ventricular assist device pump thrombosis with the HVAD using tissue-type plasminogen activator thrombolysis in nine patients with 16 thrombotic events...
January 1, 2017: European Heart Journal. Acute Cardiovascular Care
Michał Mazurek, Gregory Yh Lip
No abstract text is available yet for this article.
January 1, 2017: European Heart Journal. Acute Cardiovascular Care
Matilde Winther-Jensen, Jesper Kjaergaard, Jens F Lassen, Lars Køber, Christian Torp-Pedersen, Steen M Hansen, Freddy Lippert, Kristian Kragholm, Erika F Christensen, Christian Hassager
AIM: The purpose of this study was to describe the implantation of implantable cardioverter defibrillator after out-of-hospital cardiac arrest caused by myocardial infarction in Denmark 2001-2012 and subsequent survival. METHODS: The Danish Cardiac Arrest Registry was used to identify patients ⩾18 years surviving to discharge without prior implantable cardioverter defibrillator. Information on cardioverter defibrillator implantation was obtained from the National Patient Registry...
January 1, 2017: European Heart Journal. Acute Cardiovascular Care
Trygve Husebye, Jan Eritsland, Reidar Bjørnerheim, Geir Ø Andersen
BACKGROUND: Echocardiography is recommended for assessment of left ventricular systolic function in patients with acute heart failure but few randomised trials have validated techniques like tissue Doppler (TDI) and speckle tracking (STE) in patients with acute heart failure following ST-elevation myocardial infarction. METHODS: This was a substudy from the LEAF (LEvosimendan in Acute heart Failure following myocardial infarction) trial (NCT00324766 ), which randomised 61 patients developing acute heart failure, including cardiogenic shock, within 48 hours after ST-elevation myocardial infarction, double-blind to a 25-hour infusion of levosimendan or placebo...
January 1, 2017: European Heart Journal. Acute Cardiovascular Care
Raphael Wurm, Anna Cho, Henrike Arfsten, Raphael van Tulder, Christian Wallmüller, Philipp Steininger, Fritz Sterz, Kristina Tendl, Csilla Balassy, Klaus Distelmaier, Martin Hülsmann, Gottfried Heinz, Christopher Adlbrecht
BACKGROUND AND AIM OF THE STUDY: Non-occlusive mesenteric ischaemia (NOMI) is characterised by hypoperfusion of the intestines without evidence of mechanical obstruction, potentially leading to extensive ischaemia and necrosis. Low cardiac output appears to be a major risk factor. Cardiopulmonary resuscitation aims at restoring blood flow after cardiac arrest. However, post restoration of spontaneous circulation, myocardial stunning limits immediate recovery of sufficient cardiac function...
January 1, 2017: European Heart Journal. Acute Cardiovascular Care
Floriane Zeyons, Laurence Jesel, Olivier Morel, Hélène Kremer, Nathan Messas, Sebastien Hess, Ulun Crimizade, Philippe Reydel, Laurent Tritsch, Patrick Ohlmann
BACKGROUND: Out-of-hospital cardiac arrest (OHCA) remains a major public health issue. Emergency coronary angiography and percutaneous coronary intervention might improve survival, especially when cardiac arrest is caused by acute myocardial infarction (AMI). However, identifying patients with AMI after OHCA remains challenging. The aim of this study was to determine the clinical and ECG criteria in OHCA that may help to identify better the patients with AMI. METHODS: Consecutive OHCA patients who underwent emergency coronary angiography in our centre between 2009 and 2013 were included in this retrospective single-centre observational study...
March 2017: European Heart Journal. Acute Cardiovascular Care
Francois Schiele, Chris P Gale, Eric Bonnefoy, Frederic Capuano, Marc J Claeys, Nicolas Danchin, Keith Aa Fox, Kurt Huber, Zaza Iakobishvili, Maddalena Lettino, Tom Quinn, Maria Rubini Gimenez, Hans E Bøtker, Eva Swahn, Adam Timmis, Marco Tubaro, Christiaan Vrints, David Walker, Doron Zahger, Uwe Zeymer, Hector Bueno
Evaluation of quality of care is an integral part of modern healthcare, and has become an indispensable tool for health authorities, the public, the press and patients. However, measuring quality of care is difficult, because it is a multifactorial and multidimensional concept that cannot be estimated solely on the basis of patients' clinical outcomes. Thus, measuring the process of care through quality indicators (QIs) has become a widely used practice in this context. Other professional societies have published QIs for the evaluation of quality of care in the context of acute myocardial infarction (AMI), but no such indicators exist in Europe...
February 2017: European Heart Journal. Acute Cardiovascular Care
Ciro Mastroianni, Nadia Bouabdallaoui, Pascal Leprince, Guillaume Lebreton
INTRODUCTION: Cardiogenic shock carries a high mortality rate despite aggressive medical treatment. The Impella® Recover® LP 5.0 Support System is a microaxial minimally invasive ventricular assist device designed for short-term mechanical circulatory support in low cardiac output states. The aim of this study is to assess the safety of the Impella 5.0 device, using the right axillary artery approach, in cardiogenic shock managed at La Pitié-Salpêtrière Hospital. METHODS: Since December 2010 and during a period of 14 months, 14 highly selected patients underwent surgical implantation of an Impella 5...
February 2017: European Heart Journal. Acute Cardiovascular Care
Niklas Schofer, Fabian J Brunner, Michael Schlüter, Francisco Ojeda, Tanja Zeller, Stephan Baldus, Christoph Bickel, Karl J Lackner, Thomas Münzel, Stergios Tzikas, Sabine Genth-Zotz, Ascan Warnholtz, Felix Post, Till Keller, Britta U Goldmann, Stefan Blankenberg
BACKGROUND: The determination of cardiac troponin is essential for diagnosing myocardial infarction. A troponin I assay has recently been developed that provides the highest analytical sensitivity to date. METHODS: The analysis included 1560 patients with chest pain, of whom 1098 were diagnosed with non-coronary chest pain, 189 with unstable angina pectoris and 273 with non-ST-segment elevation myocardial infarction. The troponin I concentration was determined on admission (0 hours) and 3 hours later...
February 2017: European Heart Journal. Acute Cardiovascular Care
Frank Breuckmann, Matthias Hochadel, Thomas Voigtländer, Michael Haude, Claus Schmitt, Thomas Münzel, Evangelos Giannitsis, Harald Mudra, Gerd Heusch, Burghard Schumacher, Sebastian Barth, Gerhard Schuler, Birgit Hailer, Dirk Walther, Jochen Senges
BACKGROUND: Regional healthcare projects improve the off-hour care of patients with acute coronary syndromes and persistent ST-segment elevation myocardial infarction (STEMI). To analyse differences in quality of care between on and off-hour care of STEMI patients admitted to certified German chest pain units. METHODS: A total of 1107 STEMI patients from the German chest pain unit registry were enrolled. Analyses comprised critical time intervals (symptoms to first medical contact (FMC), FMC to admission, symptoms to admission, symptoms to balloon, FMC to balloon, door to balloon times) and major adverse cardiac and cerebrovascular events at follow-up...
February 2017: European Heart Journal. Acute Cardiovascular Care
Ravi B Patel, Sara Tannenbaum, Ana Viana-Tejedor, Jianping Guo, KyungAh Im, David A Morrow, Benjamin M Scirica
BACKGROUND: In acute coronary syndrome (ACS), potassium levels <3.5 mEq/L are associated with ventricular arrhythmias. Current guidelines therefore recommend a potassium target >4.0 mEq/L in ACS. Our study evaluated the association between potassium levels, cardiac arrhythmias, and cardiovascular death in patients with non-ST-segment elevation myocardial infarction or unstable angina. METHODS: Potassium levels were measured in 6515 patients prior to randomization to receive either ranolazine or a placebo in the MERLIN-TIMI 36 trial...
February 2017: European Heart Journal. Acute Cardiovascular Care
Roza Meyer-Saraei, Suzanne de Waha, Ingo Eitel, Steffen Desch, Bruno Scheller, Michael Böhm, Bernward Lauer, Meinrad Gawaz, Tobias Geisler, Oliver Gunkel, Leonhard Bruch, Norbert Klein, Dietrich Pfeiffer, Gerhard Schuler, Uwe Zeymer, Holger Thiele
BACKGROUND: In the randomised TATORT-NSTEMI trial routine thrombus aspiration in comparison with standard percutaneous coronary intervention (PCI) did not reduce the primary endpoint of microvascular obstruction assessed by cardiac magnetic resonance imaging in patients with non-ST-elevation myocardial infarction (NSTEMI). So far, no data on long-term outcome of head-to-head comparisons between both treatment strategies in NSTEMI patients have been reported. METHODS: The prospective, controlled, multicentre, randomised, open-label TATORT-NSTEMI trial assigned patients with NSTEMI and thrombus-containing lesions to aspiration thrombectomy plus PCI ( n=221) or standard PCI only ( n=219)...
February 2017: European Heart Journal. Acute Cardiovascular Care
Ph Gabriel Steg, Deepak L Bhatt
No abstract text is available yet for this article.
February 2017: European Heart Journal. Acute Cardiovascular Care
Etienne Puymirat, Julia Caudron, Philippe G Steg, Gilles Lemesle, Yves Cottin, Pierre Coste, François Schiele, Axel de Labriolle, Vincent Bataille, Jean Ferrières, Tabassome Simon, Nicolas Danchin
AIMS: Current guidelines recommend short time delays from qualifying ECG to reperfusion therapy in ST-elevation myocardial infarction (STEMI) patients. Recently, however, it has been suggested that shortening door-to-balloon times might not result in lower mortality, thereby questioning the relevance of current guidelines. The aim of this study was to assess in-hospital and one-year mortality in patients with fibrinolysis or primary percutaneous coronary intervention (PPCI) according to guidelines-recommended times to reperfusion therapy...
February 2017: European Heart Journal. Acute Cardiovascular Care
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